Are triage questions sufficient to assign fall risk precautions in the ED? - 19/04/17
, Lauren Slattery, DPT b, Joseph A. Rosenthal, MD, MPH c, Deborah Kegelmeyer, DPT, MS d, Anne Kloos, PhD dAbstract |
Objectives |
The American College of Emergency Physicians Geriatric Emergency Department (ED) Guidelines and the Center for Disease Control recommend that older adults be assessed for risk of falls. The standard ED assessment is a verbal query of fall risk factors, which may be inadequate. We hypothesized that the addition of a functional balance test endorsed by the Center for Disease Control Stop Elderly Accidents, Deaths, and Injuries Falls Prevention Guidelines, the 4-Stage Balance Test (4SBT), would improve the detection of patients at risk for falls.
Methods |
Prospective pilot study of a convenience sample of ambulatory adults 65 years and older in the ED. All participants received the standard nursing triage fall risk assessment. After patients were stabilized in their ED room, the 4SBT was administered.
Results |
The 58 participants had an average age of 74.1 years (range, 65-94), 40.0% were women, and 98% were community dwelling. Five (8.6%) presented to the ED for a fall-related chief complaint. The nursing triage screen identified 39.7% (n=23) as at risk for falls, whereas the 4SBT identified 43% (n=25). Combining triage questions with the 4SBT identified 60.3% (n=35) as at high risk for falls, as compared with 39.7% (n=23) with triage questions alone (P<.01). Ten (17%) of the patients at high risk by 4SBT and missed by triage questions were inpatients unaware that they were at risk for falls (new diagnoses).
Conclusions |
Incorporating a quick functional test of balance into the ED assessment for fall risk is feasible and significantly increases the detection of older adults at risk for falls.
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| ☆ | Funding sources/disclosures: All authors report support by a grant from the Cummings Endowment for Research in the School of Health and Rehabilitation Sciences at Ohio State University to perform this study. In addition, LTS is supported by a Falls Prevention Coalition Grant from the Ohio Department of Health, Office of Injury Prevention Partnership. The use of Research Electronic Data Capture database technology is supported by the Ohio State University Center for Clinical and Translational Science grant support via a National Center for Advancing Translational Sciences Grant, UL1TR001070. |
| ☆☆ | Meeting presentations: Accepted for poster presentation at 2016 American College of Emergency Physicians Research Forum. Southerland, LT; Slattery, L; Rosenthal, JA; Kegelmeyer, D; and Kloos, A. “Are triage questions sufficient to assess fall risk in the ED?” |
| ★ | Conflict of interests: None reported. |
| ★★ | Author contributions: LTS, JAR, DK, and AK conceived the study, designed the trial, and obtained research funding. LTS, LS, and DK supervised the conduct of the study, data collection, and quality control. LTS and AK analyzed the study data. LTS drafted the manuscript, and all authors contributed substantially to its revision. |
Vol 35 - N° 2
P. 329-332 - février 2017 Retour au numéro
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